Posterior vertebral column resection and intraoperative manual traction to correct severe post-tubercular rigid spinal deformities incurred during childhood: minimum 2-year follow-up

Guohua Lü, Bing Wang, Yawei Li, Lei Li, Hong Zhang, Ivan Cheng

Research output: Contribution to journalArticlepeer-review

Abstract

Results: No perioperative mortality occurred among the patients. The average follow-up was 42.8 ± 13.1 months (range 25–60 months). Kyphosis improved from a preoperative average of 93.4° ± 10.1° to a postoperative average of 18.7° ± 6.3° for a correction of 80.1 %. The Cobb angle in the coronal plane improved from an average of 48.1° ± 18.9° to 10.3° ± 3.0° postoperatively for a correction of 76.3 %. At the last follow-up, two patients improved neurologically from ASIA grade C to grade D, and one patient improved from grade C to grade E. Only one patient with ASIA grade D deficits did not improve. Perioperative complications occurred in 4 of the 11 cases. One patient had a dural tear. Three patients had temporary degradation of intraoperative neuromonitoring, and one experienced transient paralysis of the left lower extremity postoperatively.

Conclusions: PVCR and intraoperative manual traction are effective alternatives to manage severe post-tubercular spinal deformity although the procedure can be highly challenging with possible neurologic complications.

Purpose: To evaluate the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) and intraoperative manual traction to correct severe post-tubercular spinal deformity incurred during childhood.

Methods: A retrospective review of 11 patients’ (4 males and 7 females) charts was performed. Clinical outcome assessment was performed using Oswestry Disability Index and Visual Analog Scale for back pain. Imaging measurements and fusion status were assessed using plain radiography and computed tomography. Intraoperative and postoperative complications were recorded.

Original languageEnglish (US)
Pages (from-to)586-593
Number of pages8
JournalEuropean Spine Journal
Volume24
Issue number3
DOIs
StatePublished - Mar 19 2015
Externally publishedYes

Keywords

  • Children
  • Manual traction
  • Tuberculosis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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